for long periods of time, he will often develop hallucinations and other psychotic symptoms to avoid this pain.

In addition, the first terrifying fear we experience as a child is the fear of being abandoned, of being left alone. Also, according to research at the Massachusetts General Hospital on dying patients, the fear of being abandoned is one of the last fears we experience in this life. And it is my conviction that because of divorce rates and family disintegration that millions of people in this country today struggle at some level throughout their lives with some form of loneliness.

Let me say in conclusion, Mr. Chairman, that in a brief look at the research in this area we have observed the high divorce rate and other trends in this Nation having a profound effect, not only on children but on all aspects of our society. As this divorce rate exploded upward in the sixties and seventies, clinical and laboratory research indicates that it is no coincidence that this trend was followed closely by a parallel increase in juvenile violent crime and in the tendency of a huge segment of our society to use psychoactive drugs.

This drug taking began in the early sixties among a few college students on the east and west coast. Today it involves between a quarter and a half of our entire population; 20 million people smoke marihuana daily, that one drug alone.

A vast body of research has shown that the drug-taking population today, like the same population in the early sixties when it was much smaller, is comprised of people of disaffection and rebellion, who tend to come from broken and disorganized homes.

Chairman MILLER. Let me interrupt you there. Those were the second bells, so we have to vote now. We will return soon for the rest of your conclusion. Please excuse us.

[Recess.]

Mr. LELAND [presiding]. We are going to proceed. Dr. Nicholi, if you would continue.

Dr. NICHOLI. Well, I was saying that as the divorce rate began to increase in the sixties and then in the late sixties began to shoot straight up right through the seventies, with this accelerated rate there has also been an increase, a parallel increase in juvenile violent crime and the use of psychoactive drugs, and a vast body of research has shown that the absence of a parent through death, divorce, or time-demanding job contributes to many forms of emotional disorder, especially the anger, rebelliousness, low selfesteem, depression, poor academic performance, and antisocial behavior that characterizes drug users.

The same characteristics that characterized drug users, this small group who began in the early sixties, interestingly enough, characterizes the large group of drug users today. They still have the same characteristics that distinguish them from the rest of the non-drug-using population.

Let me just make a few comments in closing about recommendations. Suffice it to say that the Government I think must recognize that families are the vital cells that constitute the flesh and blood of our society. When one family disintegrates, so does a part of our society.

Government must attempt through the media and through every means possible to change the Nation's attitude toward the family, so that it is given a higher priority. It seems to me that the Government and many of the institutions in this country are unthinkingly antifamily, and I think we need a revolution.

Mr. LELAND. Can you back up and repeat that, please?

Dr. NICHOLI. I said that I think that many of the institutions in our society are unthinkingly antifamily. I think this is true with our Governments as with our educational institutions, and our business corporations, and so forth. They think and plan without giving any thought to the family. The family is kind of a body out there that is a necessary evil that you give time to and then get back to what is really important.

Because human behavior is complex, research must come from many different disciplines. The Government must help the Nation become aware that poor academic performance, susceptibility to peer influence, and delinquent behavior, as well as suicide and homicide, have been found to be higher among children from divorced homes or homes in which one or both parents are missing or frequently absent.

The disruption of families not only imposes a vast economic burden on the Nation, but inflicts upon individual citizens more sorrow and suffering than war, poverty, and inflation combined. Once these facts are comprehended, the Government and the entire Nation will realize that the problem of divorce and these other trends that adversely affect the family can no longer be neglected.

To spend vast sums of money in other areas while neglecting the area of divorce and family dissolution is like placing an expensive roof on a house while neglecting the raging fire in the basement of that house.

I want to close by commending this committee for beginning an exploration of this problem.

[Prepared statement of Armond M. Nicholi follows:]

PREPARED TESTIMONY OF ARMAND M. NICHOLI, JR., M.D., HARVARD MEDICAL SCHOOL, MASSACHUSETTS GENERAL HOSPITAL

If one factor influences the character development and emotional stability of a person, it is the quality of the relationship he experiences as a child with both of his parents. Conversely, if people suffering from severe nonorganic emotional illness have one experience in common, it is the absence of a parent through death, divorce, time-demanding job or absence for other reasons. A parent's inaccessibility either physically, emotionally, or both, can exert a profound influence on the child's emotional health. These impressions come from a vast body of research which began over three decades ago and that led the World Health Organization over twenty years ago to make this statement: "What is believed to be essential for mental health is that the infant and young child should experience a warm, intimate, and continous relationship with his mother . . ." and then presented evidence that many forms of psychoneuroses and character disorders are to be attributed to the absence of the mother or to discontinuities in the child's relationship with his mother. In the years following that statement, research throughout the world has demonstrated that a separation from the mother, even for brief periods of hosptialization, and the quality of the mother's relationship with the child, can profoundly affect both the child's physical and emotional development. And more recent research has demonstrated the full emotional impact on the child of the missing or inaccessible father. What has been shown over and over again to contribute most to the emotional development of the child is a close, warm, sustained and continuous

relationship with both parents. Yet the accelerating divorce rate and several other trends today in our society makes this most difficult to attain.

The ever-increasing divorce rate subjects an ever-increasing number of children to physically and emotionally absent parents. The divorce rate has risen 700 percent in this century and continues to soar. Over a million children a year are involved in divorce cases; 13 million (over half of all U.S.) children under 18 have one or both parents missing. Within three years after the divorce decree half the fathers never see their children. Because of divorce, an increasing number of homes have only one parent. One parent families are growing at 20 times the rate of two parent families. The increasing numbers of married women who have joined the labor force and work outside of the home-especially those mothers with young children have a profound effect on family life. In 1948, 18 percent of the nation's mothers worked outside of the home. In 1971 this figure jumped to 43 percent. Today it is over 50 percent. The frequent articles describing how this phenomenon has increased marital stress and contributed to the high rate of divorce have become all too familiar. What I find most disturbing about this phenomenon is that an ever-increasing percentage of the mothers who work are mothers of very young children, and who must work because of economic necessity.

The obtrusion of the television set into the American home has had an effect on the American family that we have not yet even begun to fathom. Parental inaccessibility contributes to children spending enormous amounts of time watching television. The television set has become a babysitter in many homes. Television acts as a two-edged sword. It both results from and causes parental inaccessibility. When parents are home physically, television often interferes with the meaningful interaction between members of the family.

We are just beginning to experience the first generation brought up completely on television. Some studies have shown that the average viewing time of the American child from 6 to 16 years of age is between 20 and 24 hours per week. If he lives to be 80, and that continues throughout his life, he will have spent 8 to 10 years of his life watching television. Or to put it another way, if he lives to be 80, he will have lived a little less than 30,000 days. Because he sleeps one-third of that time, he lives about 20,000 days. One-fifth of his waking life or about 4,000 days will have been spent watching television. We have only begun to realize the full impact of this phenomenon on family life. Research showing the effects of T.V. violence on the behavior of both children and adults has been less than encouraging.

These are only a few of several trends contributing to a change in child-rearing that has been taking place in this country during the past few decades. The change is this: in American homes today child-care has shifted from parents to other agencies. A home in which both parents are available to the child emotionally as well as physically has become, in some areas of our society, the exception rather than the rule. And I refer not only to the disadvantaged and divorced home where the father is missing and the mother works. I refer to even the most affluent homes. Crosscultural studies show that United States parents spend considerably less time with their children than almost any other country in the world. Although both Russian parents work and although Russian children spend a great deal of time in family collectives, emotional ties between children and parents are stronger and the time spent together is considerably greater than in the United States; there is relatively little juvenile delinquency in Russia. Some Russian fathers have said they would never let a day go by without spending two hours with their sons. A study in a small community in this country of how much time fathers spend with their very young sons shows that the average time per day is about 37 seconds.

From my clincial experience and from my research with college students, I began to notice (1) that a large number suffered from an incapacitating symptomatic or characterological conflict, (2) that they seemed to have in common a number of traumatic early experiences with a rejecting, inaccessible or absent parent, and (3) when we looked at their histories carefully, there appeared to be some causal relation between the earlier experiences and the emotional illness they were suffering as an adult. About 15 years ago I began studying several hundred young men who had dropped out of Harvard for psychiatric reasons. Two characteristics of the group were (1) a marked isolation and alienation from their parents, especially their fathers, and (2) an overwhelming apathy and lack of motivation. In addition, among those who had the most serious illness, that is, those hospitalized and diagnosed as schizophrenic, a large number lost one or both parents through death; when compared with several control groups, this finding proved highly significant statistically. This provided me with my first clue that there might be a relation between a missing parent and emotional illness. As I begin to work with patients clinically, I begin to realize that absence through death was the most severe kind of absence,

but that there were many other kinds of absence. Recent studies we conducted among school children this past year in a Boston suburb indicated that children who had experienced divorce or death within the family had a statistically significant, strikingly higher incidence of emotional disorder than children from intact families. Over the past few years, research studies have been carried out throughout the world trying to refine our understanding of this phenomenon and trying to refine our understanding of this phenomenon and trying to understand why some children are paralyzed by the loss of a parent through divorce or death and others seem to be unaffected (in the same way some people are paralyzed by polio and others not). The research is fascinating and we could spend several hours discussing it.

Studies on missing fathers have been carried out in several different countries. One published in the Archives of General Psychiatry, studied the periodic absence of the father on 200 children seen at a military medical clinic where the father's absence was due to his military occupation. The children ranged from 3 to 18 years of age.

The researchers found early reaction to the father's departure resembled reactions to children who lose a father by death: (1) rageful protest over desertion, (2) denial of the loss and an intense fantasy relationship with the parent, (3) efforts at reunion, (4) irrational guilt and a need for punishment, (5) exaggerated separation anxieties and fears of being abandoned, (6) a decrease in impulse control, and (7) a wide variety of regressive symptoms.

When the father left home, the child was often allowed to do things not otherwise permitted. This made it difficult for the child to internalize a consistent set of standards for controlling his behavior. In several instances, the father's leaving was followed by disobedience, decline in school performance, and aggressive antisocial behavior. The child seemed unable to control himself and this loss of control is especially interesting in light of the observation that more people today come to psychiatrists because of a lack of impulse control.

Several other recent studies bear on the absence or inaccessibility of the father and all point to the same conclusions: A father absent for long periods contributes to (a) low motivation for achievement, (b) inability to defer immediate gratification for later rewards, (c) low self-esteem (d) susceptibility to group influence and to juvenile delinquency. The absent father tends to have passive, effeminate, dependent sons lacking in achievement, motivation and independence. These are general findings with, of course, many exceptions.

Most children experience an absent parent as rejection and rejection inevitably breeds resentment and hostility. The child may express this outwardly in the form of violence or inwardly in the form of self-injury. The suicide rate in 10 to 14 year olds in the United States has doubled and in children 15 to 19 has tripled during the past 20 years. These trends have resulted in our society producing a staggering number of angry, depressed and suicidal children. Research indicates that the loss or absence of a parent predisposes a child to a variety of emotional disorders that manifest themselves immediately or later in the child's life.

What about the future? What can we expect if the divorce rate continues to soar? First of all, the quality of family life will continue to deteriorate, producing a society with a higher incidence of mental illness than ever before known. Ninety-five percent of our hospital beds may be taken up by mentally ill patients. The nature of this illness will be characterized primarily by a lack of impulse control. In this impluse ridden society of tomorrow we can expect the assassination of people in authority to be an every-day occurrence. All crimes of violence will increase, even those within the family. Because battered children—if they survive-tend to become parents who in turn abuse their children, the amount of violence within the family will increase exponentially. Aggression turned inward will also increase and the suicide rate will continue to soar.

What can we do about them? We must take steps to reverse this process of producing empty and angry young people whose rage erupts either in uncontrolled violence or in depression and self-destruction. When a famiily disintegrates-to reduce it to its simplest terms-both children and adults suffer a form of intense loneliness-the most painful and most frightening of human experiences. Loneliness is so painful to even contemplate that modern psychiatry has pretty much avoided the study of it. People suffering from nonorganic disorders prevalent today-drug addicts, alcoholics, workaholics, and even psychotics-may in larger measure be attempting to avoid the pain of loneliness. When a person is left alone on a raft or in a chamber for long periods of time, he will often develop hallucinations and other psychotic symptoms to avoid this pain. In addition, the first terrifying fear we experience as a child is the fear of being abandoned, of being left alone. Also, according to research at the Massachusetts General Hospital on dying patients, fear of being

abandoned is one of the last fears we experience in this life. And it is my conviction that because of divorce and family disintegration millions struggle with loneliness at some level throughout their lives-regardless of how closely they work with people. For professional relationships can never give us the emotional sustenance and support that the close, warm, personal relationships a healthy family life provide.

CONCLUSION

In a brief look at research in this area we have observed the high divorce rate and other trends in this nation have a profound effect not only on children but on all aspects of our society. As this divorce rate exploded upward in the late 60's and throughout the 70's, clinical and laboratory research indicates that it is no coincidence that this trend was followed closely by a parallel increase in juvenile violent crime and the tendency of a huge segment of our society to use psychoactive drugs. This drug taking began in the early's 60's among a few college students on the east and west coast. Today it involves between a quarter and a half of our entire population. Twenty million people smoke marijuana daily. A vast body of research has shown that the drug-taking population today, like this same population in the early 60's when it was much smaller, is comprised of people of disaffection and rebellion who tend to come from broken and disorganized homes. This same vast body of research has shown that the absence of a parent through death, divorce or time-demanding job, contributes to many forms of emotional disorder-especially the anger, rebelliousness, low self-esteem, depression, poor academic performance, and antisocial behavior that characterizes drug users. Time limits discussing any detailed recommendations for action. (1) Suffice it to say that the government must recognize fully that families are the vital cells that constitute the flesh and blood of our society. When one family disintegrates, so does a part of our society. (2) Government must attempt through the media and through every means possible to change the nation's attitude toward the family so that it is given the highest priority. (3) Government must encourage and sponsor research into the causes of divorce. Because human behavior is complex and multidetermined, research must come from many disciplines. (4) The government must help the nation become aware that poor academic performance, susceptibility to peer influence and delinquent behavior as well as suicide and homicide have been found to be higher among children from divorced homes in which one or both parents are missing or frequently absent.

The disruption of families not only imposes a vast economic burden on the nation but inflicts upon individual citizens more sorrow and suffering than war, poverty and inflation combined. Once these facts are comprehended, the government and the entire nation will realize that the problem of divorce can no longer be neglected. To spend vast sums of money in other areas while neglecting the area of divorce is like placing an expensive roof on a house while neglecting a raging fire in the basement of that house. I commend this committee for beginning an exploration of this problem.

Mr. LELAND. Thank you very much, doctor.

I am not sure who wants to go next.

STATEMENT OF RITA KRAMER, AUTHOR

Mrs. KRAMER. Mr. Chairman, members of the committee: I am going to start with an apology for beginning my remarks to you today by talking about myself. My only excuse for doing so is the one given by Henry David Thoreau at the beginning of "Walden,' where he says:

I should not talk so much about myself if there were anybody else I knew as well. Unfortunately, I am confined to this theme by the narrowness of my experience. Of course, like Thoreau before me, I am being a bit less than ingenuous. Like him, I find reason to believe that my own experiences-and my reflections on those experiences-have some general relevance to the situation in which we all find ourselves today. The situation to which I refer is a shifting of values I see as more than the expectable change that comes with time, technology, and thought as every generation succeeds its parents, and as one from